| NPI | 1003278664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD470206) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: DE C1-0013183) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2020-11-17 |